Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Edwin Bacalso

Individual provider Clinical Social Worker · NPI 1023661659

Edwin Bacalso is a Clinical Social Worker in Thiensville, Wisconsin. Practices as a sole proprietor. Licensed in Wisconsin.

Licensed in
WI
In the registry since
2019
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Practice location Address checks out

13111 N Port Washington Rd
Thiensville, WI 53097-2416
Phone: (262) 243-6127
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 131474-121 (WI)

Record details

NPI number1023661659
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJuly 23, 2019
Last updated in NPPESMay 7, 2024
Certification dateMay 7, 2024

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